Open access scheduling: Improving access to rural healthcare

Shakira Lynn, Barbara J. Edlund, Bonnie P. Dumas


Background and Purpose: Open access scheduling is a model that allows patients to choose appointments at their convenience in an effort to provide timely access to healthcare.  Healthcare providers typically have overbooked schedules that make it difficult to provide access to primary care appointments for patients in need without long wait times.  The purpose of this quality improvement project was to implement open access scheduling at a federally-qualified health center to evaluate the number of missed patient appointments and the amount of time it takes to receive an appointment.

Methods: Patient appointments (N=1,333) were analyzed via the Allscripts™ electronic computer system.  During project implementation, staff utilized a written protocol for open access that had been tested at a satellite office with successful results.  Patients were placed in appointment slots daily as they were available.

Conclusions: The highest no-show rate prior to implementation was 42%, which improved after open access to 27%.  Average TNAA trended downward post-implementation from 8.9 days three-months pre-intervention to 4.3 days three-months post-implementation.  This scheduling model was successful in decreasing no-show rates by allowing patients to be seen in a timely manner and can be utilized in primary care to improve access to healthcare.

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Journal of Nursing Education and Practice

ISSN 1925-4040 (Print)   ISSN 1925-4059 (Online)

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